PTSD And ‘A Sense Of A Foreshortened Future.’

The DSM 4 (Diagnostic And Statistical Manual Of Mental Illness, 4th Edition) lists one of the symptoms of posttraumatic stress disorder (PTSD) as a ‘sense of a foreshortened future.‘ It is this specific symptom that I wish to concentrate upon in this article.

The psychologists Ratcliffe et al. (2014) suggested, based on their research, that this involved several elements of altered feelings, perceptions and beliefs, some of which I consider (although not exclusively) below.

NEGATIVE VIEW OF THE FUTURE :

An individual suffering from a ‘sense of a foreshortened future’ may have an extremely negative and pessimistic set of beliefs about the future ; these may include :

I will die young / soon / prematurely / imminently

I will never have a rewarding and successful career

I will never find a partner / have a family.

In other words, the individual who is experiencing a ‘sense of a foreshortened future‘ regards the future as bleak, empty a without meaning.

It follows.of course, that the person’s feelings and emotions in relation to the future will also be negative – rather than being hopeful about it, s/he may fear and dread it.

ALTERATIONS IN PERCEPTION OF TIME :

Also, such a person may experience severe alterations in his/her perception of how time operates, including :

changes in perception of the passage of time and feeling unable to ‘move forward into the future’

changes in how PAST, PRESENT and FUTURE are experienced

changes in how the relationship between the PAST, PRESENT and FUTURE are experienced

the experience of flashbacks (in which the past is experienced as ‘happening now.’

a change in perception of the overall structure of experience

FEELING THAT LIFE IS OVER :

Freeman (2000) coined the term ‘narrative foreclosure’ which refers to a strong sense that one’s ‘life story has effectively ended.’ and that there is no further purpose to it, no further meaning that can be derived from it and no possibility that it will contain deep relationships with others or achievement of any kind. The individual affected in this way may also cease to feel s/he cares about anything or can be committed to any cause or project in the future.

In short, a sense of nihilism may prevail.

LOSS OF TRUST :

Also relevant to an individual developing a sense of a foreshortened future is that it is likely to be intertwined with a general loss of trust which may manifest itself through beliefs such as :

others cannot be trusted and pose a threat to me

the world is a dangerous place that I should interact with as little as possible

THE ‘SHATTERING’ OF ONE’S EXPERIENCE OF WORLD AND OF OTHER PEOPLE :

Greening (1990) puts forward the view that the individual’s ‘relationship with existence itself becomes shattered’. For example, the experience of trauma may leave the individual with a fundamentally altered views about the safety of the world (Herman, 1992) and his/her place within it ; the world seems meaningless, other people undependable and dangerous, and the self of no value.

LOSS OF PREDICTABILITY :

The individual, too, may come to see life as essentially random and unpredictable, feel that s/he can exercise no control over it, and that, therefore, there is no prospect of life unfolding in a dependable, coherent, cohesively structured way – s/he may feel s/he is no longer travelling through life on a reasonably straight set of tracks, but, rather, on tracks that twist and turn at random and from which one may be completely derailed at any time without warning. Indeed, Stolorow (2007) refers to how the individual may lose his/her sense of ‘safety’ and and of any meaningful ‘continuity’ in life.

Such a person may feel that ‘anything can happen at any time’ and that these things will, inevitably, be very bad. Because of this, s/he may feel perpetually trepidatious and vulnerable – alone in a an alien, sinister, hostile and frightening world ; a world in which there is no structure to hold one in place, no coherence and nowhere one can feel safe or a sense of belonging ; it can seem as if the foundations of one’s life are now built on sand rather than on solid ground and, as such, one’s life is liable to collapse at any time and without warning.

AN UNSHAKABLE SENSE OF IMMINENT DEATH :

Any future goals the individual had may now seem meaningless and pointless – even absurd ; linked to this can be a feeling that one is no longer moving forward in life and that there is no worthwhile direction in which life can go – any direction feels equally futile and devoid of meaning.

And, because the individual now sees only emptiness lying ahead of him/her in life this can translate into a perception that future time itself has somehow dissolved and has been replaced by a kind of ‘temporal vacuum’. This, in turn, leads to a feeling that nothing of meaningful substance lies between the present and death. Future time is anticipated as a void and in this sense ceases to be real – therefore, DEATH FEELS ABIDINGLY AND PERPETUALLY IMMINENT ; no buffer of a meaningful, substantive, solid, structured, ‘block of time’ is perceived to lie between NOW and DEATH’S OCCURRENCE ; instead, just a nebulous, indistinct haze of ‘virtual nothingness.’ (This is a difficult concept to relate to, or, even, comprehend if one has not experienced such an unhappy state of being – or, perhaps more accurately put, non-being – oneself).

To all intents and purposes, therefore, to an individual suffering from a ‘sense of a foreshortened future, it feels as if one’s life is already over. Indeed, Herman (1992) noted that it was not unusual for those who had been affected by the experience of severe trauma reported feeling as if they were dead or as if part of them had died.